AB0596 APPLICABILITY OF THE ACR-1997, SLICC-2012, AND EULAR/ACR 2019 CLASSIFICATION CRITERIA IN ADULT-ONSET SYSTEMIC LUPUS ERYTHEMATOSUS AND CHILDHOOD-ONSET SYSTEMIC LUPUS ERYTHEMATOSUS

Background

Over the past few decades, several classification criteria have been proposed for systemic lupus erythematosus (SLE), including the American College of Rheumatology (ACR)-1997, Systemic Lupus International Collaborating Clinics (SLICC)-2012, and European Alliance of Associations for Rheumatology (EULAR)/ACR-2019. The sensitivity and specificity of these classification criteria are inconsistent for the various races of SLE patients [1-3]. Patients with SLE who are younger than 18 year old are called childhood-onset SLE (c-SLE), which differ from adult-onset SLE (a-SLE) in several ways. The applicability of classification criteria for c-SLE of different races were also inconsistent [4-6]. Now, there is a lack of data to verify the applicability of classification criteria in a-SLE or c-SLE in northern China.

Objectives

This study is to verify the applicability of classification criteria in a-SLE and c-SLE in northern China, and explore the most applicable disease evaluation standards.

Methods

81 c-SLE vs 59 pediatric controls, 80 a-SLE vs 76 adult controls were included in the study. All the participants are Chinese descent living in northern China. The control groups were diagnosed with other rheumatic diseases. The diagnosis of these patients was determined by two or more rheumatologists. We reviewed the clinical manifestations and laboratory tests of these patients with respect to three classification criteria.

Results

The sensitivity of EULAR/ACR-2019 and SLICC-2012 was higher than that of ACR-1997 in a-SLE group, but there was no significant difference in the specificity, with AUCs of EULAR/ACR-2019 (0.863), SLICC-2012 (0.895), and ACR-1997 (0.865). In c-SLE group, the sensitivity of SLICC-2012 was higher than that of ACR-1997, and the specificity was not significantly different, with AUCs of EULAR/ACR-2019 (0.94), SLICC-2012 (0.945), and ACR-1997 (0.899). Increasing the threshold of EULAR/ACR-2019 from 10 to 11 can improve the specificity and accuracy for a-SLE, while from 10 to 14 can improve those for c-SLE.

Conclusion

EULAR/ACR-2019 and SLICC-2012 are the most appropriate classification criteria for a-SLE, and SLICC-2012 is more applicable for c-SLE from northern China. Adjusting the threshold of EULAR/ACR-2019 can improve the specificity and accuracy for a-SLE and c-SLE.

References

[1]ADAMICHOU C, NIKOLOPOULOS D, GENITSARIDI I, et al. In an early SLE cohort the ACR-1997, SLICC-2012, and EULAR/ACR-2019 criteria classify non-overlapping groups of patients: use of all three criteria ensures optimal capture for clinical studies while their modification earlier classification and treatment. Annals of the rheumatic diseases, 2020, 79: 232-41. [2]TENG J, YE J, ZHOU Z, et al. A comparison of the performance of the 2019 European League Against Rheumatism/American College of Rheumatology criteria and the 2012 Systemic Lupus International Collaborating Clinics criteria with the 1997 American College of Rheumatology classification criteria for systemic lupus erythematous in new-onset Chinese patients. Lupus, 2020, 29: 617-24. [3]JOHNSON S R, BRINKS R, COSTENBADER K H, et al. Performance of the 2019 EULAR/ACR classification criteria for systemic lupus erythematosus in early disease, across sexes and ethnicities. Annals of the rheumatic diseases, 2020, 79: 1333-9. [4]ALJABERI N, NGUYEN K, STRAHLE C, et al. Performance of the New 2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus in Children and Young Adults. Arthritis Care Res, 2021, 73: 580-5. [5]LEVINSKY Y, BROIDE M, KAGAN S, et al. Performance of 2019 EULAR/ACR classification criteria for systemic lupus erythematosus in a paediatric population-a multicentre study. Rheumatology, 2021, 60: 5142-8. [6]CHENG S, DING H, XUE H, et al. Evaluation of the 2019 EULAR/ACR classification criteria for systemic lupus erythematosus in children and adults. Clin Rheumatol, 2022, 41: 2995-3003.

Acknowledgements:

NIL.

Disclosure of Interests

None Declared.